Table Of ContentGlobal health in africa
Historical Perspectives on Disease Control
edited by tamara Giles-vernick and james l. a. webb, jr.
Global HealtH in africa
PersPectives on Global HealtH
Series editor: James L. A. Webb, Jr.
The History of Blood Transfusion in Sub-Saharan Africa,
by William H. Schneider
Global Health in Africa: Historical Perspectives on Disease Control,
edited by Tamara Giles-Vernick and James L. A. Webb, Jr.
Global HealtH in africa
Historical Perspectives on Disease Control
Edited by Tamara Giles-Vernick and
James L. A. Webb, Jr.
Ohio University Press
Athens
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COVer PHOTOS: (top left) WHO Photo 1991, ArCO 12, PrINT-AFrO-MALArIA. “After the spraying is
completed in any house the foreman records the date of spraying on the wall.” Photograph by P. Palmer. WHO Copy-
right; (top center) courtesy Tamara Giles-Vernick; (top right) WHO Photo 11761, ArCO 12, PrINT-AFrO-MALArIA.
“Laboratory Technicians Collect Blood Specimens From School Children in a Survey to Determine the Incidence of
Malaria in the Town of Ho.” Photographer Unknown. WHO Copyright; (primary image) courtesy Tamara Giles-Vernick
23 22 21 20 19 18 17 16 15 14 13 5 4 3 2 1
Library of Congress Cataloging-in-Publication Data
Global health in Africa : historical perspectives on disease control / edited by Tamara Giles-
Vernick and James L. A. Webb, Jr.
pages cm. — (Perspectives on global health)
“Global Health in Africa had its beginnings in 2008, at a one-day workshop at Princeton
University”—Acknowledgments.
Includes bibliographical references and index.
ISBN 978-0-8214-2067-6 (hc : alk. paper) — ISBN 978-0-8214-2068-3 (pb : alk. paper) —
ISBN 978-0-8214-4471-9
1. Public health—Africa—Congresses. 2. Medical policy—Africa—Congresses. 3. Africa—
Social conditions—Congresses. 4. Public health—International cooperation—Congresses. I.
Giles-Vernick, Tamara, [date]– editor of compilation. II. Webb, James L. A., Jr., [date]– editor of
compilation. III. Series: Perspectives on global health.
rA545.G56 2013
614.4096—dc23
2013026979
COntents
Acknowledgments vii
Introduction 1
JAMeS L. A. WeBB, Jr. AND TAMArA GILeS-VerNICk
PArT I. LookInG BAck
The Long History of Smallpox eradication
One
Lessons for Global Health in Africa 25
WILLIAM H. SCHNeIDer
The First Large-Scale Use of Synthetic Insecticide
twO
for Malaria Control in Tropical Africa
Lessons from Liberia, 1945–62 42
JAMeS L. A. WeBB, Jr.
A Genealogy of Treatment as Prevention (TasP)
three
Prevention, Therapy, and the Tensions of Public
Health in African History 70
GUILLAUMe LACHeNAL
The True Fiasco
fOUr
The Treatment and Prevention of
Severe Acute Malnutrition in Uganda, 1950–74 92
JeNNIFer TAPPAN
PArT II. ThE PAsT In ThE PrEsEnT
People, Great Apes, Disease, and Global Health
five
in the Northern Forests of equatorial Africa 117
TAMArA GILeS-VerNICk AND STePHANIe rUPP
Defenseless Bodies and Violent Afflictions in a Global World
six
Blood, Iatrogenesis, and Hepatitis C Transmission in Egypt 138
ANNe MArIe MOULIN
v
“Snake in the Belly”
seven
Africa’s Unhappy Experience with Cholera during
the Seventh Pandemic, 1971 to the Present 159
MyrON eCHeNBerG
PArT III. ThE PAsT In ThE FuTurE
Male Circumcision and HIV Control in Africa
eight
Questioning Scientific Evidence and the
Decision-Making Process 185
MICHeL GAreNNe, ALAIN GIAMI,
AND CHrISTOPHe Perrey
Heroin Use, Trafficking, and Intervention Approaches
nine
in Sub-Saharan Africa
Local and Global Contexts 211
SHeryL MCCUrDy AND HArUkA MArUyAMA
About the Contributors 235
Index 239
vi
contents
ACknOwledgments
Global Health in Africa had its beginnings in 2008, at a one-day
workshop at Princeton University. We are grateful to Princeton University’s
Center for Collaborative History, Center for Health and Wellbeing, Depart-
ment of History, Shelby Cullom Davis Center for Historical Studies, and
environmental Institute for their financial support for the workshop and to
emmanuel kreike for his gracious efforts in facilitating it. emmanuel Akyeam-
pong, Jean-Paul Bado, Barbara Cooper, Susan Craddock, Steve Feierman, Mat-
thieu Fintz, emmanuel kreike, Burton Singer, and Helen Tilley made incisive
contributions to our workshop discussions and influenced the direction that
the resulting volume has taken.
The editors express thanks to their home institutions. Tamara Giles-Vernick
conveys her gratitude to Arnaud Fontanet and members of the Institut Pas-
teur Unit of emerging Diseases epidemiology for generously sharing their
perspectives on global public health and to Sylvana Thépaut for her superb
administrative assistance. Jim Webb thanks colleagues in the Department of
History and the Program in Global Studies at Colby College for a congenial
work environment and in the administration at Colby College for their sup-
port of a National Institutes of Health/National Library of Medicine grant
that provided time for research and writing.
The volume has entailed extensive back-and-forth communications be-
tween the editors and the contributors, and we are grateful for the spirit of
collegiality and goodwill of our contributors. Many of the ideas, interpreta-
tions, and data in these essays have been tested in conference presentations in
a wide variety of university and research settings, and we are appreciatively
aware that the contributions have been strengthened as a result. An earlier
version of William Schneider’s essay on smallpox appeared in Medical History
53, no. 2 (2009), and a slightly modified version of the essay on malaria by Jim
Webb was published in the Journal of the History of Medicine and Allied Sciences
66, no. 3 (2011).
We thank Patrick Zylberman and Aline Munier for their insights, com-
ments, and suggestions on the various essays in this volume. The external re-
viewers engaged by the Ohio University Press likewise wrote astute reports
that provided helpful guidance for revisions. Gill Berchowitz, director of Ohio
vii
University Press, was continuously supportive of the project and a pleasure to
work with.
The editors thank their spouses, ken Vernick and Alison Jones Webb, for
their critical readings, intellectual exchanges, and good humor.
viii
acknowledgments
intrOdUCtiOn
JAMeS L. A. WeBB, Jr. AND TAMArA GILeS-VerNICk
Global health history is a new research field, and to date we
know little about the histories of global health initiatives in Africa.1 In one
sense, this is quite surprising. Africa’s disease burden is heavy, and international
and bilateral agencies, philanthropic organizations, nongovernmental organi-
zations (NGOs), and public-private partnerships in league with African gov-
ernments have undertaken a broad array of interventions against individual
diseases and into health care systems over the past many decades. Most of
these interventions were time-limited, ran their courses, and were forgotten.
Later iterations of these programs generally took scant advantage of the earlier
experiences. There were no specialists charged with understanding the past ex-
periences, and thus there was no systematic effort to analyze the performance
of global health programs and to investigate the reasons for failure and partial
success. The lessons of the past have thus remained largely unarticulated or
misconstrued, unable to inform contemporary global health efforts.
Global Health in Africa is a first exploration of some of the histories of
global health initiatives in Africa. The volume is published with the intention
of developing the new field of global health history in order to broaden the
training of a new generation of public health professionals. Our goal is to
promote historical and anthropological research that integrates the social sci-
ences and the biomedical sciences in the service of global public health.2 This
approach owes much to the subdiscipline of historical epidemiology, which
evaluates the changing nature of disease over space and time; it integrates so-
cial, political, economic, and ecological processes with those of pathogens and
with the effects of global health initiatives themselves. In bringing together
biomedical and social science approaches, historical epidemiology sharpens
our understandings of the biosocial causes of ill health and helps us grasp why
some interventions fail.
To date, in the development, implementation, and expansion of public
health projects, planners generally have not sensed a first imperative to un-
derstand the worlds in which their projects would operate. It has not been
their charge to appreciate political constraints and resource scarcities or to
